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眼弓形体病:当前诊断和治疗方法的综述。

Ocular toxoplasmosis: a review of the current diagnostic and therapeutic approaches.

机构信息

Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Stavros Niarchos Ave, 45500, Ioannina, Greece.

Microbiology Department, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.

出版信息

Int Ophthalmol. 2022 Jan;42(1):295-321. doi: 10.1007/s10792-021-01994-9. Epub 2021 Aug 9.

Abstract

PURPOSE

This review aims to summarize the current knowledge concerning the clinical features, diagnostic work-up and therapeutic approach of ocular toxoplasmosis focusing mainly on the postnatally acquired form of the disease.

METHODS

A meticulous literature search was performed in the PubMed database. A supplementary search was made in Google Scholar to complete the collected items.

RESULTS

Ocular toxoplasmosis is one of the most frequent infectious etiologies of posterior uveitis. It typically presents with retinochoroiditis. Setting an accurate diagnosis depends to a considerable degree on detecting characteristic clinical characteristics. In addition to the evaluation of clinical features, the diagnosis of toxoplasmosis relies at a large degree on serologic testing. The detection of the parasite DNA in the aqueous or vitreous humor can provide evidence for a definitive diagnosis. The current mainstay for the treatment, if necessary, is the use of oral antibiotic with systemic corticosteroids. Recent evidence suggests other therapeutic approaches, such as intravitreal antibiotics can be used.

CONCLUSION

Recent developments in the diagnostic and therapeutic approach have contributed to preventing or limiting vision loss of patients suffering from ocular toxoplasmosis. Further studies are required to provide a better understanding of epidemiology, pathogenesis, diagnosis, and treatment with a significant impact on the management of this challenging clinical entity.

摘要

目的

本综述旨在总结眼弓形体病的临床特征、诊断方法和治疗方法,重点关注后天获得性眼弓形体病。

方法

在 PubMed 数据库中进行了细致的文献检索。在 Google Scholar 中进行了补充搜索,以完成收集的项目。

结果

眼弓形体病是后葡萄膜炎最常见的感染性病因之一。它通常表现为脉络膜视网膜炎。准确诊断在很大程度上取决于发现特征性临床特征。除了评估临床特征外,弓形体病的诊断还在很大程度上依赖于血清学检测。在房水或玻璃体液中检测到寄生虫 DNA 可以提供明确诊断的证据。目前,如果需要,治疗的主要方法是使用口服抗生素联合全身皮质类固醇。最近的证据表明,可以使用其他治疗方法,如玻璃体内抗生素。

结论

诊断和治疗方法的最新进展有助于预防或限制眼弓形体病患者的视力丧失。需要进一步研究以更好地了解流行病学、发病机制、诊断和治疗,这对管理这种具有挑战性的临床实体具有重要影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0a3/8351587/17f1e85f5f1a/10792_2021_1994_Fig1_HTML.jpg

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